Inspection Sheet

-Valid license to operate; non-transferable

PIC present, demonstration of knowledge, performs duties

Special processes (Variance, ROP, shellfish tanks, HACCP)

Ill workers? PIC & EMP responsibilities: Report symptoms and diagnosis; restrict/exclude (removal, retain, or adjust)

Hands clean, washed, maintained; hand antiseptics

No bare hand contact with RTE foods or alternate methods; Glove limitations

Adequate hand wash facilities: supplied, accessible; toilets properly supplied

Food, water, ice obtained from approved source

Food in good condition, safe, unadulterated, segregated

Required records (shellstock tags, parasite destruction)

Food separated/protected; proper tasting procedures; self-serve operations; single service use when required

Disposition of returns, previously served, reconditioned, unsafe food.

Prohibited animals; prohibited food operation locations

Sinks used for intended purposes

Food equipment; improper use, operation (materials, design)

Insects, rodents, and other pest control

Cooking time and temperatures; plant food cooking

Reheating procedures for hot holding

Cooling time and temp; cooling methods

Hot holding temps; received at proper temp.

Cold holding temps; received at proper temp

Date marking and disposition

Time as public health control, procedures/ records

Non-continuous cooking process/partial cook

Adequate facilities/equipment to maintain food temps

Probe thermometers provided and accurate

Consumer advisory, child menu, allergen label

Pasteurized food used; prohibited food not offered; pasteurized eggs used where required

Food additives; approved, properly used

Toxic substances properly identified, stored, used

Warewashing, sanitize equipment: Design, supplies, operated; test strips, temp gages, alarms

Warewashing; sanitize at ppm/temp

Food contact surfaces of equipment and utensils clean

Water: adequate pressure, sufficient capacity

Plumbing sewage system: design, approved, installed

• Cross connection prohibited
• Air gaps, disposal

Approved thaw methods; actively cooling containers stored properly

Thermometers provided, accurate, conspicuous

Food properly labeled, original container, honestly presented

Contamination prevented during food prep, storage, and display; washing fruits/vegetables

Personnel: clean, jewelry, hair restraints, FH permits

Eating drinking, tobacco use; no discharge from eyes, mouth, nose, ears

Wiping cloths: properly used and stored; sponges prohibited

In-use utensils proper storage, cleaning frequency; utensils, equipment and linens: properly stored, dried, and handled; linens clean

Single-use, single-service articles properly stored, used

Food and non-food contact surfaces cleanable design

Manual/mechanical warewashing facilities: maintained, operated; Pressure gauges, data plates; Use limitation, pre-cleaning

Plumbing system: maintained, backflow device installed, inspected

Toilet facilities: accessible, properly constructed, cleaned; self closures

Break/locker areas: used, provided, maintained; living areas separated; laundry facilities

Hand wash sinks: designed, clean, used; proper signage

Floors, walls, ceilings (premises): clean, free of litter; removal of pests

Floors, walls, ceilings (physical facilities): design, maintained, good repair; outlet openings protected

Service sinks; maintenance and cleaning tools: use, storage

Outdoor areas: constructed, maintained clean

Garbage/refuse: properly disposed, facilities construction, maintained

Ventilation: installed, maintained; lighting: adequate, shielded

Other

• 1. Five or more marked CDC risk factors
• 2. Eleven or more marked of items 1-35
• 3. Six or more marked of any items 1-35 plus eight or more of items 36-58